The James: By the Numbers
10 years in the making
1.1 million square feet
306 total cancer beds including: 276 acute care including a 24-bed blood and marrow transplant unit
and 30 intensive care
21 floors with research laboratories on every inpatient floor
16 cancer emergency department stations
14 operating rooms
7 vaults with state of the art linear accelerators for radiation therapy
5 interventional radiology suites
SOURCE: The Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute
Advice for newly diagnosed patients
David Pitsch of Springfield: "If you try to process everything about what you think is happening and going to happen, you can't do it. You'll be crushed. So take it one step at a time. Go out and get information but be careful not to get too much information. The internet will tell you every bad thing that will ever happen on that particular drug. All that stuff doesn't happen. … People survive. We don't hear much about survivors, because they just want to be normal. They just want to go back to their deal, raise their kids and do their job. We hear all the time about people who don't survive because it's a tragedy. But there are lots of people out there that make it. We need to hear from those people."
Gary Bush of Beavercreek: "Be your own advocate. I'm not saying you're not going to find good treatment here, and I believe they're going to change what's being done here (by the work at) Ohio State. If you're not comfortable with your diagnosis from your doctor … get another opinion."
Jamie Ozias of Liberty Twp.: Ozias said one way for people to beat cancer is to prevent its occurrence if possible. "People sometimes don't take care of themselves," he said. He also said those newly diagnosed with hard-to-treat cancers should not lose hope. "Down the road, there's always something better that's not out yet."
Denis Mangen of Centerville: Keep hope and stay positive. "I think attitude is important. I think support is important. You have to have faith and you have to have trust and you just do what you can. Never give up."
Krista Hammond Mang of Beavercreek: The first thing anyone diagnosed with cancer should do is get informed, Mang said. "Educate yourself. That's the most important thing. Learn everything you can but don't believe everything you read on the internet," she said. "And find a doctor with whom you can get along on a personal level as well as being health partners for treatment."
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Everything about Ohio State’s new cancer center, due to open in December, is big.
Really big.
The $750 million facility has 21 floors — each dedicated to a different type of cancer — 1.1 million square feet and 306 beds. Even the name is a mouthful: The Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
But perhaps the most impressive number is three. The James, as it is commonly called, has long had a reputation as a premier cancer hospital. But with the new building and its many advances, the James will rise into an elite category nationally, becoming the nation’s third-largest cancer hospital. And that will change the dynamic of how cancer care is delivered in Ohio.
The James is part of a wave of developments that is giving the region more treatment options than at any time in history. The Cleveland Clinic just announced it is building a $276 million outpatient cancer building.
Premier Health and Kettering Health Network have added new technologies to expand cancer care options close to home. Dayton Children’s will integrate inpatient and outpatient cancer care in their Comprehensive Cancer and Blood Disorders Center in a new 260,000 square foot patient tower.
The almost dizzying array of treatment options and research trials available reflects both the preponderance of cancer incidences and the number of living, breathing Americans who are getting care that is helping them live productive lives.
The five-year relative survival rate for all cancers diagnosed between 2003 and 2009 is 68 percent, according to the American Cancer Society. That’s up from 49 percent from 1975 to 1977, and is attributed to progress in diagnosing cancers at early stages and improvements in treatment.
Several local people are among the survivors.
Gary Bush of Beavercreek credits leukemia treatments he got at the James for his chance to walk his daughter down the aisle at her wedding this fall.
David Pitsch of Springfield is a three-time cancer survivor who was able to compete in triathlons after recovering from lymphoma.
Jamie Ozias of Liberty Twp. was close to death after being diagnosed with leukemia in 2006.
“He could barely climb the stairs of our house,” said his wife, Kim, of Ozias, 74. “The progress he has undergone with this treatment is amazing.”
Bush, Pitsch and Ozias are among the 4,000 people from the Miami Valley who visited the James in 2013.
The treatments available there and elsewhere are by no means defeating cancer. About 585,720 Americans are expected to die of the disease this year — nearly 1,600 people per day. Cancer accounts for nearly one in every four deaths.
But there also are more strategies for addressing the disease, and more state-of-the-art facilities like the James that deal with a numbing reality: cancer is ubiquitous.
Approximately 13.7 million Americans with a history of cancer were alive as of January 2012 and more than 1.6 million cases are expected to be diagnosed in 2014. By 2030, the number of new cancer cases in the United States will increase by 45 percent, from 1.6 million to 2.3 million, according to “The State of Cancer Care in America,” a report by the American Society of Clinical Oncology.
People are living longer, and more are living with a disease that seems destined to become the nation’s leading cause of death. That in turn is putting more of an emphasis on finding cures.
“We had the realization that looking at the math, we didn’t have enough room to do what it is that we want to do, which is to cure cancer,” said Dr. Michael Caligiuri, director of the Ohio State University Comprehensive Cancer Center and CEO of the James Cancer Hospital and Solove Research Institute. “Growing population, living longer, increased incidence of certain types of cancer leads to a need for increased bed capacity and clinic capacity.”
The James has been outgrowing its existing space of 160 beds and “bled into the rest of our medical center with another 60 beds,” Caligiuri said. “So we are up to 220 to 230 beds to hold the fort.”
About the James
The new hospital will have private rooms and enough space for visitors during inpatient stays, said Dr. Sameek Roychowdhury, assistant professor, Department of Internal Medicine, Division of Medical Oncology, Department of Pharmacology.
“You’re here to visit. You’re here to add comfort. You’re here to help the family,” he said. “A little bit of space is a big deal when it comes to family.”
The hospital will boast the first fully integrated cancer emergency department in the United States, meaning emergency medicine physicians and staff will have additional training in oncology.
“The idea is to have something unique, something that moves things quickly for patients instead of sitting hours in the emergency room with complications that we know we can handle,” Caligiuri said.
Floors dedicated to different types of cancer will allow the center to move quickly and better customize care, in some cases using DNA testing to pinpoint treatment, he said.
“Every cancer is unique, and the way you get at the uniqueness of your cancer versus my cancer is looking at the DNA very, very quickly, and figure out what your specific mutation causing your leukemia is and what your treatment should be,” Caligiuri said.
Labs on every inpatient floor will allow staff to examine blood, move to the lab and quickly do DNA diagnostics — the type of precision cancer treatment made possible through technology advances and the Human Genome Project, the sequencing of genes that has been called one of the great feats of exploration in history.
The $3.8 billion project, completed in 2003, provided a genetic blueprint of the human body and a strategy for how treatments can, in some cases, be individualized. DNA testing is not unique to the James — Premier and Kettering are testing in their hospitals — but it is integral to much of the treatment being done at Ohio State’s cancer center.
“This is cutting-edge science, cutting-edge technology,” Roychowdhury said. “It’s slightly expensive, but we can do things that we couldn’t even dream of doing in 2000 or 1998 or 2004.”
The $750 million investment in the James is part of a $1.1 billion revitalization of research, patient care and education spaces at the sprawling Ohio State University Wexner Medical Center campus. The James investment includes a $100 million grant from the U.S. Department of Health and Human Services for an above-ground radiation therapy treatment center and a brachytherapy unit.
Radiation typically is done underground, but the new facility — the only one of its kind in the country — is designed in part to relieve depression in patients through the use of natural light.
Caligiuri said the facility will help attract more of the nation’s best physicians and researchers to Ohio State.
“The way it works is talent,” he said. “We’re all trying to have the best and brightest physicians we can from around the country, from around the world. Certainly having a beautiful, new 1.1 million square foot cancer hospital is very attractive.
“Those are the things that attract talent, and it’s that talent that then attracts the research grants.”
Cancer patients — those who can and will go anywhere — no longer have to go elsewhere to get the best care, according to Caligiuri.
“When you hear the three words — you have cancer — you’re thinking, ‘I have to go see this person or that person,’ ” he said. “We have those people here at the James.”
Caligiuri said the university has recruited about 300 physicians and scientists focused on cancer care during the past 15 years, including physicians from Johns Hopkins and Harvard.
Evolving treatment
Research, often done through clinical trials, has helped to evolve cancer treatment.
The James is one of 41 National Cancer Institute-designated Comprehensive Cancer Centers, and one of only two in Ohio (the other is at Case Western Reserve University). The designation means, in part, that physicians and scientists collaborate to translate laboratory research into clinical practice.
“(They are) providing translational research or research that goes from bench to bedside,” said Dr. Gregory Masters, chair of the American Society of Clinical Oncology’s Cancer Communications Committee and a medical oncologist at the Helen F. Graham Cancer Center in Newark, Del.
It was one of those clinical trials that stopped Gary Bush’s leukemia from multiplying. He showed noticeable results just seven days after starting his regimen of pills — what he calls his “little silver bullets.” Today, less than four years after he began taking the drug Ibrutinib, his symptoms are gone.
Clinical trial opportunities are not exclusive to large cancer centers. The Dayton Clinical Oncology Program offers national cancer clinical trials through the National Cancer Institute and its community oncology research programs.
Participating hospitals and medical centers in DCOP include Premier Health Partners, Kettering Health Network, Wayne Hospital, Blanchard Valley Health System, Oncology Hematology Care in Cincinnati, the Dayton VA Medical Center and Boonshoft School of Medicine at Wright State University.
Physicians participating in DCOP meet regularly to discuss oncology clinical trials, said Dr. Charles Bane, an oncologist, chair of the Cancer Institute for Premier Health and president of Dayton Physicians Network. Bane said DCOP has more than 60 clinical trials available for a wide variety of cancer types and stages.
DCOP is one of two sites in the state to receive funding through the National Cancer Institute’s Community Oncology Research Program (NCORP).
More than 1,000 cancer patients in the region during the past five years have received treatment through DCOP research studies, Bane said.
Kettering Health Network had 336 participants in clinical studies in 2013. Of the network’s newly diagnosed cancer patients, 13 percent entered a cancer clinical trial — exceeding the American College of Surgeons Commission on Cancer standard of 6 percent, a spokesperson said.
Close to home
One of the advantages of a comprehensive cancer center is that patients like Denis Mangen of Centerville can get a second opinion.
After a routine colonoscopy in 2009, Mangen was diagnosed with colon and liver cancer. He said his local specialist warned him he may live only two years. He was referred to Ohio State, where he has undergone a number of surgeries, and in November — five years after his initial diagnosis — Mangen plans on attending his son’s wedding.
Second opinions also can reassure patients that they are getting the most up-to-date care at home, Masters said.
“With communication the way it is, in clinical practice, most treatments and evaluations and therapies are determined based on large clinical trials and extensive national experience,” he said. “And those treatments and the ones we use are based on national guideline recommendations.”
Traveling for treatment can be hard on cancer patients, particularly if frequent treatments are required. Bane said 95 percent of cancer treatment is outpatient “and all outpatient procedures and treatments are available here.”
Locally, about 17,600 patients received some form of cancer care through Premier Health and Kettering Health Network last year, according to the networks.
Local health systems offer a full range of cancer services, according to Bane and Elizabeth Koelker, executive director at Kettering Health Network. Neither Kettering nor Premier have formal partnerships with the James but will refer patients to the most appropriate facility for care, officials said.
Kettering Health Network offers a network-wide approach to cancer services, Koelker said.
“(We have an) understanding that cancer affects the mind, body and spirit,” she said. “Our treatment plans and our staffing and our services are all centered around taking care of the patient throughout the care continuum.”
Koelker noted new technologies adopted at Kettering including being the first in the country to use the Elekta Versa HD, a radiation therapy system designed to deliver precise, high doses of radiation in shorter increments of time.
Kettering also has instituted a new cancer call system, “because we know that the hours and days following cancer diagnosis are very emotional and frightening and confusing.” Patients can call the number to arrange doctor visits, tests and to help navigate the entire cancer process.
Bane pointed to Oncology Medical at Home, a three-year project through Medicare that is being trialed by seven practices in the country, including his. The project, in progress for two years, provides high-quality, low-cost care for cancer patients locally, he said. Patients can get same-day, evening or weekend appointments. Most issues, he said, can be addressed in the office rather than sending a patient to the emergency room.
Mark Shaker, president and CEO of Miami Valley Hospital, said in some cases patients who go to the James are directed back to Premier.
“It’s a lot less burdensome,” he said. “It goes both ways.”
Masters, noting that medicine is becoming increasingly competitive, said competition can both help and hurt cancer patients.
“In general, I think it’s good there’s competition to provide the best care to allow patients to get what they need — in terms of their understanding of their disease; in terms of treatment options; in terms of the latest clinical trials with new ideas of maybe not completely proven treatments but encouraging research ideas. All those are things that work in a patient’s favor.”
But, he added, “Most people don’t have an extensive background in what they really need. They are influenced by the marketing of it. So the best-case scenario is that a new cancer center goes up and everyone provides better care … and patients win.
“But worst-case scenario, there’s increased financial competition and offering of services that may not be in the best interest of the patient and may not be the best use of resources.”
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